Gerald A Beltre-Tavares, MD
Individual provider Active NPI General Practice Physician · Gurabo, PR
NPI 1134895659 · NPPES record last updated Oct 18, 2021
Key facts
- NPI
- 1134895659
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 22420 (PR)
- Practice address
- Urb. Vistalago #64 Calle Lago la Plata
Gurabo, PR 00778 - Phone
- (939) 268-8679
- NPI assigned
- Aug 17, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220929000402 | PR | Practitioner - General Practice | 4880079052 | Practice locations: San Juan, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 22420 | PR | Yes |
Addresses
Primary practice location
Urb. Vistalago #64 Calle Lago la Plata
Gurabo, PR 00778
Mailing address
Urb. Vistalago #64 Calle Lago la Plata
Gurabo, PR 00778
Phone (939) 268-8679
Other providers in Gurabo, PR
- Magda I Arroyo
- Jarymar Arzon
- Avivir LLC
- Ba Emergency Medical Products LLC
- Karla Baez Rios
- Christian Johan Benitez
- Daphne Benson
- Hector Bernardo
- Yarisel Berrios Flores
- Karim Berrios Gomez
All providers in Gurabo, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.